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Background. First identified and reported in September 2012 as an agent causing severe acute respiratory illness, Middle East Respiratory Syndrome Coronavirus (MERS-CoV) has caused infections worldwide, including in the United States. To date all reported cases have been linked directly or indirectly to travel through, or residence in, countries in or near the Arabian Peninsula*. The majority of cases have been reported from Saudi Arabia where there is evidence for ongoing, sporadic introductions from animals (e.g., camels) to humans, followed by both healthcare-related and limited community human-to-human transmission.

Purpose of guidance. CDC has created this interim guidance for state and local health jurisdictions to use to monitor people within the United States (U.S.) potentially exposed to MERS-CoV and evaluate their intended travel, including the application of movement restrictions when indicated (Table 1). This guidance applies to people who are within the U.S. and have been exposed to a confirmed MERS case or have been present in a setting in which MERS cases occurred (e.g., hospital), either overseas or in the U.S. The guidance does not apply to travelers entering the U.S. without known links to a confirmed MERS case. Currently CDC and state health departments are not performing enhanced risk assessment to screen travelers for MERS who are arriving in the U.S. from the Arabian Peninsula*. This guidance provides public health authorities and other partners with a framework for determining the appropriate public health actions based on risk exposure and clinical presentation. This interim guidance is based on the current context of lack of ongoing MERS-CoV transmission in the U.S., and will be updated if the epidemiology of MERS-CoV changes.

CDC continues to recommend that healthcare providers and health departments throughout the U.S. be prepared to detect and manage cases of MERS. Healthcare providers should continue to routinely ask their patients about their travel history and healthcare facility exposure overseas and to consider a diagnosis of MERS-CoV infection in people who meet the criteria for a patient under investigation (PUI).

Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection, based on CDC's case definition for a patient under investigation: www.cdc.gov/coronavirus/mers/case-def.ht...

Published guidance recommends controlled movement for persons with higher-risk exposures (HREs) to communicable diseases of public health concern; US federal public health travel restrictions (PHTRs) might be implemented to enforce these measures. We...

FOR EXTERNAL DISTRIBUTIONNewly updated information is indicated in redIn this document:• Summary Key Messages• Second Imported Case of MERS in U.S.• First Imported Case of MERS in U.S.• Updates on Ongoing Investigations of Contacts• MERS Ca...

FOR EXTERNAL DISTRIBUTIONNewly updated information is indicated in redIn this document:• Summary Key Messages• Second Imported Case of MERS in U.S.• First Imported Case of MERS in U.S.• MERS Cases and Deaths Worldwide (WHO)• What CDC is Doi...